REBEL Cast

Take Home Points Severe hypocalcemia can cause hypotension and QTc prolongation leading to Torsades de Pointes.  Treat moderate to severe symptoms and any EKG changes with IV calcium salts Always search for and treat the underlying cause of hypocalcemia REBEL Core Cast 88.0 – Hypocalcemia Click here for Direct Download of the Podcast Definition: A ... Read more

Take Home Points Patients with severe hypercalcemia (> 14 mg/dL) are at risk for severe cardiac dysrhythmias and cardiac collapse Treatment centers on volume repletion with normal saline with consideration for the addition of loop diuretics AFTER volume reexpansion is complete As the patient begins to diurese, continually monitor electrolytes REBEL Core Cast 87.0 – ... Read more

REBEL Core Cast 86.0 – Hand Nerve Blocks Click here for Direct Download of the Podcast References: Core Ultrasound: Median Nerve Block Core Ultrasound: Radial Nerve Block Core Ultrasound: Ulnar Nerve Block Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)

Background: Hypoxemia is a commonly encountered adverse event during rapid sequence intubation (RSI) in the ED.  Critically ill patients in the ED often have a lack of physiologic reserve, decreased cardiac output, increased shunting, and reduced pulmonary reserves.  Therefore, a strategy that safely avoids desaturation and prolongs safe apnea times would be beneficial. There are ... Read more

Background:  Some of the feared complications of endotracheal intubation include hypotension, cardiac arrest, and death (cardiovascular collapse).  These complications can result from numerous causes including medication-induced vasodilation and decreased venous return to the heart due to increased intrathoracic pressure from positive pressure ventilation. In recent years there has been an increased focus on resuscitation prior ... Read more

Take Home Points SVT >5cm or <3 cm from the SFJ should be treated with anti-coagulation.  The rate of concurrent DVT and PE in patients with SVT is 25% and 5%, respectively.  REBEL Core Cast 85.0 – Superficial Venous Thrombosis Click here for Direct Download of the Podcast Definition: The presence of a clot in ... Read more

Take Home Points AVNRT is a common tachydysrhythmia that results from a reentrant loop within the AV node. Unstable patients with AVNRT should be considered for immediate synchronized electrical cardioversion. Stable patients with AVNRT can have a trial of vagal maneuvers followed by chemical cardioversion with adenosine or verapamil and synchronized electrical cardioversion if that ... Read more

Take Home Points Post dural-puncture headache affects up to 30% of patients after lumbar puncture. Suspect PDPH in all patients who recently underwent an LP or epidural anesthesia regardless of whether they meet the IHS criteria. The best way to treat PDPH is to prevent it from developing. Techniques proven to reduce risk include large ... Read more

Background: Early in the COVID-19 pandemic, clinicians were looking for practical, widely available, and low-cost interventions to help patients with hypoxemia.  One of those interventions was awake prone positioning.  Potential mechanisms of benefit in awake proning include more uniform distribution of tidal volume, recruitment of areas in the posterior part of the lung, improved ventilation/perfusion, ... Read more

Take Home Points Consider AAA in patients with acute onset of back or abdominal pain particularly in patients > 50 and in those with a history of hypertension Consider ruptured AAA in patients (especially those > 50 years of age) with unexplained hypotension, back or abdominal pain All ruptured AAAs should be considered unstable regardless ... Read more